Nicolas Simioni1, Cristian Preda2, Valérie Deken2, Camille Bence3, Olivier Cottencin4, Benjamin Rolland5. 1. CHU Lille, Département de Psychiatrie et d'Addictologie, Lille, France Etablissement Public de Santé Mentale, Val de Lys - Artois, Centre de Soins d'Accompagnement et de Prévention en Addictologie, Béthune, France simioni.nicolas@gmail.com. 2. Univ. Lille, CHU Lille, EA 2694 - Santé publique : épidémiologie et qualité des soins, Lille, France. 3. CHU Lille, Département de Psychiatrie et d'Addictologie, Lille, France. 4. CHU Lille, Département de Psychiatrie et d'Addictologie, Lille, France Univ. Lille, CNRS UMR 9193, SCALab-PsyCHIC team, Lille, France. 5. CHU Lille, Département de Psychiatrie et d'Addictologie, Lille, France Univ. Lille, INSERM U1171, Département de Pharmacologie, Lille, France.
Abstract
AIM: To characterize the profile of patients seeking baclofen treatment for alcohol dependence in France. METHOD: We compared retrospectively baclofen seekers and baclofen non-seekers within a cohort of consecutive outpatients with alcohol dependence who attended a first appointment for alcohol treatment at two French addiction centres between September 2012 and March 2014. We documented socio-demographic characteristics; comorbid psychiatric, addiction, alcohol dependence features; patients' initial drinking goal, and referral status; and treatment retention at 6 and 12 months. RESULTS: Of the 289 patients identified, 107 were baclofen seekers and 182 were baclofen non-seekers. The only parameters significantly associated with baclofen seekers in multivariate analyses were a greater baseline alcohol consumption (β = 15.4, 95% CI: 0.18-30.65, P = 0.05), a controlled-drinking initial goal (OR = 14.9, 95% CI: 7.7-29, P < 0.0001) and self-referral (OR = 6.6, 95% CI: 3.7-12, P < 0.0001), baclofen seekers being eight times more likely to be self-referred and treatment-naïve (OR = 8.8, 95% CI: 4.1-18.9, P < 0.0001). Baclofen seekers were more likely to be retained in treatment at 6 months (OR = 3.5, 95% CI: 1.8-6.7, P < 0.0001) and 12 months (OR = 1.9, 95% CI: 1.1-3.2, P = 0.019). CONCLUSION: In France, the perspective of controlled drinking offered by baclofen treatment may have attracted more self-referred patients, including those without previous alcohol treatment, to attend treatment, than the usual treatment options. These findings raise the question as to whether future public health strategies on alcohol should more prominently promote some aspects of alcohol treatment, such as patient's preference and treatment options, in order to reduce the treatment gap in alcohol dependence.
AIM: To characterize the profile of patients seeking baclofen treatment for alcohol dependence in France. METHOD: We compared retrospectively baclofen seekers and baclofen non-seekers within a cohort of consecutive outpatients with alcohol dependence who attended a first appointment for alcohol treatment at two French addiction centres between September 2012 and March 2014. We documented socio-demographic characteristics; comorbid psychiatric, addiction, alcohol dependence features; patients' initial drinking goal, and referral status; and treatment retention at 6 and 12 months. RESULTS: Of the 289 patients identified, 107 were baclofen seekers and 182 were baclofen non-seekers. The only parameters significantly associated with baclofen seekers in multivariate analyses were a greater baseline alcohol consumption (β = 15.4, 95% CI: 0.18-30.65, P = 0.05), a controlled-drinking initial goal (OR = 14.9, 95% CI: 7.7-29, P < 0.0001) and self-referral (OR = 6.6, 95% CI: 3.7-12, P < 0.0001), baclofen seekers being eight times more likely to be self-referred and treatment-naïve (OR = 8.8, 95% CI: 4.1-18.9, P < 0.0001). Baclofen seekers were more likely to be retained in treatment at 6 months (OR = 3.5, 95% CI: 1.8-6.7, P < 0.0001) and 12 months (OR = 1.9, 95% CI: 1.1-3.2, P = 0.019). CONCLUSION: In France, the perspective of controlled drinking offered by baclofen treatment may have attracted more self-referred patients, including those without previous alcohol treatment, to attend treatment, than the usual treatment options. These findings raise the question as to whether future public health strategies on alcohol should more prominently promote some aspects of alcohol treatment, such as patient's preference and treatment options, in order to reduce the treatment gap in alcohol dependence.
Authors: Anna Warden; Emma Erickson; Gizelle Robinson; R Adron Harris; R Dayne Mayfield Journal: Pharmacogenomics Date: 2016-12-05 Impact factor: 2.533